In Reply.—Dr Oken has misunderstood my view if he believes I argue that the studies cited in "Cynicism Among Medical Students" show that medical students become cynical during their training. By their poor design or lack of adequate consent from students, however, they offer unintentional support for some students' claims that cynicism arises from the lack of attention given to the way important ideals are expressed in practice. This "confirmation" does not come from the studies' findings but from their flaws. Thus, there is no contradiction because I do not hold that the studies' findings confirm that students become more cynical during their training. Rather, I argue that they are too flawed to draw any conclusions. As I say in the article, we do not know "if, how, why, or when attitudes change"1(p2007); I urge that "it is important to study, systematically, if and why students become cynical."